Carotid glomus tumor. Case report

Abstract

Glomus tumors or paragangliomas are rare, slow-growing and usually benign tumors. These tumors can be found in the carotid arteries (bifurcation of the common carotid artery), the middle ear or the jugular bulb. The carotid body is a chemoreceptor located at the bifurcation of the common posteromedial carotid artery and is part of the extrasuprarenal paraganglionic system derived from neuronal crest cells. Tumors of the carotid body are the most common paragangliomas of the neck, representing 65% of the tumors found. They affect both sexes equally, being discovered between the ages of 40 and 60 years old, and may be sporadic in their nature, familial or may be part of a syndrome, such as the Carney triad, Von Hippel-Lindau disease or type I neurofibromatosis. Clinically, it presents as a pseudotumor formation, which is hard and painless, located anteriorly to the sternocleidomastoid muscle. It may remain asymptomatic for a long time. However, as the tumor grows, it compresses the nearby surrounding tissue, which may lead to dysphagia, odynophagia, dysphonia, hoarseness, stridor, stiff jaw, sore throat or any combination of these symptoms. The diagnosis is based on imaging performed with Doppler ultrasound, CT, MRI, brain angiography or PET-CT. The treatment consists in surgical excision with or without preoperative embolization. Radiation therapy, alone or in combination with the surgical treatment, is another therapeutic strategy that can be chosen for glomus tumors.